One of the greatest challenges currently facing designers of behavioral health units is in balancing patient safety without negatively impacting the creation of a therapeutic environment that is conducive to patient healing and recovery. The safety of patients, staff, and visitors is very important, but so is the therapeutic nature of the environment. Patients must be provided surroundings that are welcoming, relaxing, and comfortable, and not make them think they are being punished for being ill. Nonetheless, as the data shows, the prevalence of inpatient suicide by hanging is an area requiring increased focus and action.
Overemphasis on or an unbalanced approach to safety can result in very prisonlike environments for patients and is contrary to the current trend toward more home-like built environments in all healthcare settings, and especially those built environments for the treatment of behavioral health patients. What constitutes the right blend of safety and comfort is a very individualized issue and will vary widely among facilities.
Let’s look at the three key design considerations that need to be addressed in designing behavioral health spaces: Safety, Dignity, & Durability.
Safety
As the VA statistics show, suicide attempts by hanging are the number 1 risk. Therefore, ligature resistance must be foremost in the designer’s mind. It’s important to note that no product should ever claim to be “suicide proof” nor “anti-ligature” , however, the designer should seek out both design and product elements that reduce this risk.
Dignity
Facilities incorporating homelike features better accommodate patients and their families in a soothing setting that lowers stress, promotes safety, and improves outcomes. Finishes and furnishings to consider are: wood laminate floors, lounge furniture, carpeted bedrooms, community kitchens, and other amenities like expansive views, quiet rooms, and a library.
Durability
Beyond durable paints, walls can be protected in other ways, and the aesthetics vary with each product type. Many patients try to pick away at materials where seams are visible, so a good installation would be one in which seams are not easily noticed or can be camouflaged within the product. New digitally printed wall cladding can introduce calming art.
BLDD Architects is helping Genesis Health System implement the comprehensive expansion of their behavior health services. BLDD is currently designing their new 24-bed Geriatric Behavioral Health Unit, which will serve individuals ages 55+ who demonstrate acute mental illness.
Steve Oliver, AIA, NCARB, LEED AP Principal, Director of Healthcare
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